TRANSPORT DEPARTMENT

ASST.RTO, BULANDSHAHAR
FORM 3
[See Rule 3(a) and 13]

LEARNER'S LICENCE
Fee Details Rs.350.0/- /UPW/1834484 /27-05-2023 ApplNo: 1949388823 Issue Dt. 08-06-2023

1. Licence No. UP13 /0020952/2023

2. Name VIVEK

3. Father's Name SHIV KUMAR

4. Date of Birth 01-01-2004

5. Optional/Blood Group- Unknown

RH Factor

6. Present Address audhera urf nawada Chandaru Bulandshahr Uttar

Pradesh,203001
Holder's Signature
7. Permanent Address audhera urf nawada Chandaru Bulandshahr Uttar
Pradesh,203001

8. Marks of Identification (1)

(2)
is licenced to drive a Motor Vehicles of the following description through out India and in case of E-
rickshaw or E-cart, in specified areas or routes, as a learner,subject to the provisions of Rule 3 of
the Centeral Motor Vehicle Rules 1989:

LIGHT MOTOR VEHICLE, Motor Cycle with Gear(Non Transport),

..........................................................................................................................................................

*The holder of the licence has passed the preliminary test referred to in rule 11(1) of the CMV
Rules ,1989.
*The holder of the licence is exempted from the medical test under rule 6 and from the
Preliminary test under rule11(2)of the Central Motor Vehicle Rules,1989
*Strike off which ever is inapplicable
This Licence is valid from 08/06/2023 To 07/12/2023

Signature and Designation of

the Licensing Authority
Warning: ASST.RTO, BULANDSHAHAR
The attention of the holder of this licence is drawn to rule 3 of CMV Rules, 1989 which prohibits him from driving any
motor vehicle unless he has besides him a person duly licenced to drive the vehicle and in every case , the vehicle
carries "L" plates both in front and in the rear of the vehicle.
Note: This is a computer generated Document. No signature is required.This Learners Licence is issued based on the Information and
declaration submitted by the applicant with regards to his/her physical fitness to drive a Motor Vehicle and liable for cancelation if found
incorrect/ unfit to drive.